ABC Special Risk Plan Data Template 01112012

Department of Fire & Emergency Services of Western Australia (DFES) Special Risk Plan Data Place a Y (yes) or an N (no) in Plan No the boxes that do not require Category an explanation. 1. Business Details Name of site Built Environment Branch File No Address (Lot No ___) Special Risk Plan File No Suburb Streetsmart Map Coordinates Telephone No Fax Email AH emerg phone No GPS Map Coordinates AH contact (1) Phone Mob. AH contact (2) Phone Mob. No of people on site Day Night Weekends Staff numbers Day Night Weekends Facility unattended Dangerous goods site licence No Nature of operations Emergency Control Centre location DEC licence No Direct brigade alarm number Keys held by DFES

2. Construction Roof No. of floors Walls Basement Floors Stairs Floor area Date of Construction Arrival Action 3. Arrival Action Required 

Specific Hazard Information 4. Assessment (details on the facility that require special attention and/or areas to avoid.)

5. Hazards on Site (chemicals, UN No Class Pack. Licence Average Location fire risks, etc.) (ID No) (Division) Grp. Quantity Quantity 1. 2. 3. 4. 5. 6.

Note: This listing is only for quick reference use by emergency services and does not replace the need for a manifest. For additional information and accurate up to date listing of hazards please refer to the current manifest, which is a mandatory requirement for premises storing/handling/processing dangerous goods/ hazardous materials.

6. Material Safety Data Sheets/Manifest/Hazard Identification (Y or N and/or Location) Material safety data sheets Location Emergency services manifest Location Gas detectors Type, Loc Wind direction indicator(s) Location Wind intensity measurement Location Placarding Hazard diamonds

ABC Chemicals Perth Special Risk Plan 123 Data – Current at 01/11/2012 OPERATIONAL – IN – CONFIDENCE Access only by operational crews, authorized stakeholders & facility operator/owner Operational Information 7. Exposures

8. Means of escape Evacuation plan availability Location Protect-in-place refuges Location Staff evacuation procedures Location of in place evacuation maps Assembly areas identified Location Ground floor exits Exits - upper floors Number of lifts Fire lift Goods lift Emergency lighting Notifications: Siren Phone Radio

9. Access Emergency service access Emergency vehicle parking Back-up vehicle parking Secondary vehicle parking Aerials

10. Security provisions

11. Site Resources Available in Case of an Emergency (Y or N, Add Type, Quantity, Location etc) Technical expert(s) Site manager(s) Owner Lime (Quantity & location) Dry Sand (Quantity & location) Other neutralising agents (qty, type, loc) Absorbents – quantity, type & location Emergency trailer, SCBA, spill bins etc.

12. Additional Resources Required (i.e. Foam Trailer, Medium Tanker, Mutual Aid etc.)

13. Services/Utilities (Y or N and Location) Fire indicator panel Location Main power isolation point Location Smoke detection control point Location Sprinkler system main valve Location Hazardous gas isolation valve Location Domestic fuel/gas isolation valve Location Water isolation valve Location Stormwater isolation valve Location Wastewater isolation valve Location Sewer connection Location

14. Active Fire Safety Systems (Y or N and add note if required) Sprinkler system Sprinkler system booster Location Number of inlets Thermal alarms Fire pump room Location ABC Chemicals Perth Special Risk Plan 123 Data – Current at 01/11/2012 2 OPERATIONAL – IN – CONFIDENCE Access only by operational crews, authorized stakeholders & facility operator/owner Street hydrants-primary (Main or nearest street hydrant) Mains size (mm) Pressure (kPa) Flow rate (l/m) Street hydrants-secondary (Other local street hydrants) Mains size (mm) Pressure (kPa) Flow rate (l/m) On-site hydrants Mains size (mm) Pressure (kPa) Flow rate (l/m) Hydrant booster systems Location Number of inlets Foam Supplies (Qty, type, loc) Smoke control systems Smoke alarms Gas discharge Other alarms Other systems Hose reels Extinguishers

15. Passive Fire Systems (Y or N and add note if required) Fire walls Fire floors Fire stairs Fire rated lifts Fire rated service shaft Fire doors On-site drainage systems Bunding in place Fire wastewater containment on-site Off-site drainage systems Closest compensating basin, river system/water body, sensitive environmental receptor

16. Integration with Other Plans(Y or N + Name & Plan No)–name facilities that may be affected Affects other plans Plan Number

17. Evacuation of Surrounding Facilities and the Community (Y or N – add note) Off-site protecting in place to be Procedure considered Off-site protection in place plan Location Off-site evacuation to be considered Procedure Off-site evacuation plan Location Are responding agencies advised of Who has off-site plans? plans? Media notification required (offsite impact)

18. Neighbours-Details of Persons Present-day(d), night(n), weekend(w).

19. Environmental Considerations (Spillage containment and removal, extent of smoke plume &/or gas plume

20. Other Important Notes (Safeguards, proximity to houses, community facilities, hazards, groundwater etc)

21. Site Visits &/or Exercises (Y or N) Are They Req’d Once a Year Twice a Year Every Two Years Emergency response training required for staff

22. Monitoring, Reviewing and Maintenance of the Plan: Every 12 months, plus after Near miss Changes in surroundings & use Facility alterations

ABC Chemicals Perth Special Risk Plan 123 Data – Current at 01/11/2012 3 OPERATIONAL – IN – CONFIDENCE Access only by operational crews, authorized stakeholders & facility operator/owner 23. Location Map, Site Plan, Floor Plans – Refer Attachments

Colour Coding Arrival Action Specific Hazard Information Operational Information Administrative Information

Distribution list Local Fire Station District Officer Special Risks Coordinator DFES Extranet Special Risks Portal Site Operator (Manifest Tube/Control Centre)

ABC Chemicals Perth Special Risk Plan 123 Data – Current at 01/11/2012 4 OPERATIONAL – IN – CONFIDENCE Access only by operational crews, authorized stakeholders & facility operator/owner